Combined brachytherapy and external beam radiotherapy without adjuvant androgen deprivation therapy for high-risk prostate cancer

Radiation Oncology

Naoyuki Shigematsu¹  Yutaka Shiraishi¹  Shoji Yamashita⁵  Toru Nishiyama⁴  Tetsuo Momma²  Shiro Saito⁴  Atsunori Yorozu³  Toshio Ohashi⁵ 

[1] Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan;Department of Urology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wakho City, Saitama 351-0102, Japan;Department of Radiology, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan;Department of Urology, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan;Department of Radiology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wakho City, Saitama 351-0102, Japan

关键词: Androgen deprivation therapy;    High risk;    Brachytherapy;    Prostate cancer;   

Others  :  815087
DOI  :  10.1186/1748-717X-9-13

 received in 2013-08-13, accepted in 2014-01-03,  发布年份 2014

【 摘 要 】

Background

To report the outcomes of patients treated with combined iodine-125 (I-125) brachytherapy and external beam radiotherapy (EBRT) for high-risk prostate cancer.

Methods

Between 2003 and 2009, I-125 permanent prostate brachytherapy plus EBRT was performed for 206 patients with high-risk prostate cancer. High-risk patients had prostate-specific antigen ≥ 20 ng/mL, and/or Gleason score ≥ 8, and/or Stage ≥ T3. One hundred and one patients (49.0%) received neoadjuvant androgen deprivation therapy (ADT) but none were given adjuvant ADT. Biochemical failure-free survival (BFFS) was determined using the Phoenix definition.

Results

The 5-year actuarial BFFS rate was 84.8%. The 5-year cause-specific survival and overall survival rates were 98.7% and 97.6%, respectively. There were 8 deaths (3.9%), of which 2 were due to prostate cancer. On multivariate analysis, positive biopsy core rates and the number of high-risk factors were independent predictors of BFFS. The 5-year BFFS rates for patients in the positive biopsy core rate <50% and ≥50% groups were 89.3% and 78.2%, respectively (p = 0.03). The 5-year BFFS rate for patients with the any single high-risk factor was 86.1%, compared with 73.6% for those with any 2 or all 3 high-risk factors (p = 0.03). Neoadjuvant ADT did not impact the 5-year BFFS.

Conclusions

At a median follow-up of 60 months, high-risk prostate cancer patients undergoing combined I-125 brachytherapy and EBRT without adjuvant ADT have a high probability of achieving 5-year BFFS.

【 授权许可】

   
2014 Ohashi et al.; licensee BioMed Central Ltd.

【 图 表 】

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